Descemet's stripping with endothelial keratoplasty in 200 eyes: Early challenges and techniques to enhance donor adherence

Journal of Cataract and Refractive Surgery
Francis W Price, Marianne O Price

Abstract

To describe early challenges and techniques to promote donor tissue adherence in Descemet's stripping with endothelial keratoplasty (DSEK). Price Vision Group, Indianapolis, Indiana, USA. The first 200 consecutive cases of DSEK performed by a single surgeon were analyzed retrospectively. Follow-up was 7 to 20 months for 124 eyes and 2 to 6 months for 76 eyes. The surgical technique consisted of stripping Descemet's membrane and endothelium from the recipient's central cornea and transplanting an 8.0 to 9.0 mm disc of donor endothelium and posterior stroma through a 5.0 mm incision, with sutures used only to close the incision. The most frequent challenge was inadequate donor attachment. Using techniques to remove fluid from the donor-recipient graft interface, the donor detachment rate in the last 64 cases was 6%, with half attributable to patient eye rubbing. Detached grafts were reattached by injecting an air bubble to press the donor against the recipient cornea. There were 7 primary graft failures, with only 1 occurring in the second 100 cases, which primarily used microkeratome-dissected donor tissue. Other complications were infrequent and included pupillary block glaucoma (1), aqueous misdirection syndrome (1), and catar...Continue Reading

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References

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Jul 18, 2003·Ophthalmology·Robert W ThompsonFrancis W Price
Aug 13, 2003·Archives of Ophthalmology·Marianne O PriceFrancis W Price
Apr 16, 2004·Cornea·Gerrit R J MellesCarla P Nieuwendaal
Jun 5, 2004·Journal of Cataract and Refractive Surgery·Marianne O Price, Francis W Price
Apr 25, 2006·Journal of Cataract and Refractive Surgery·Francis W Price, Marianne O Price

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Citations

Jun 23, 2009·Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft·P Maier, T Reinhard
Jul 4, 2012·Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft·M K J KlamannP C Ruokonen
Apr 12, 2013·Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft·A-K B MaierP W Rieck
Aug 31, 2013·Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft·T RöckE Yoeruek
Nov 26, 2009·Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Für Klinische Und Experimentelle Ophthalmologie·Edgar M EspanaBo Huang
Jan 31, 2012·Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Für Klinische Und Experimentelle Ophthalmologie·Masatoshi HirayamaJun Shimazaki
Nov 28, 2012·Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Für Klinische Und Experimentelle Ophthalmologie·Anna-Karina B MaierPeter Rieck
Mar 15, 2011·Japanese Journal of Ophthalmology·Yoshiro MawatariKazuhisa Sugiyama
Feb 22, 2012·Japanese Journal of Ophthalmology·Toshinori MasakiKazuhisa Sugiyama
May 31, 2012·Japanese Journal of Ophthalmology·Naoki OzekiKazuo Tsubota
Jan 16, 2009·Bulletin of Experimental Biology and Medicine·O N KuleshovaE V Shvedova
Sep 28, 2007·International Ophthalmology·Kenneth M Goins
Jan 16, 2008·International Ophthalmology·Francis W Price, Marianne O Price
Jun 5, 2012·International Ophthalmology·Namrata SharmaRasik B Vajpayee
Nov 7, 2012·International Ophthalmology·Carla P NieuwendaalMaarten P Mourits
Mar 11, 2008·Eye·M Anandan, M Leyland
Nov 15, 2006·Cornea·Francis W Price, Marianne O Price
Nov 15, 2006·Cornea·Natalya RomanivNick Mamalis
Sep 26, 2007·Cornea·Marian Sue Macsai, Andrea Cotait Kara-Jose
Sep 26, 2007·Cornea·Bruce D S AllanMargareta Claesson
Oct 27, 2007·Cornea·Donald T H Tan, Jodhbir S Mehta
Jan 25, 2008·Cornea·Mark S GorovoyWilliam J Dupps
Aug 30, 2008·Cornea·James A SbarbaroIrving M Raber

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